法国上消化道内镜检查的诊断率。

Diagnostic yield of esophagogastroduodenoscopy in France.

机构信息

Department of Gastroenterology and Digestive Oncology, Cochin Hospital, and University of Paris, France.

出版信息

Clin Res Hepatol Gastroenterol. 2021 Jul;45(4):101540. doi: 10.1016/j.clinre.2020.08.015. Epub 2020 Oct 7.

DOI:10.1016/j.clinre.2020.08.015

PMID:33036954

Abstract

BACKGROUND AND STUDY AIMS

Large scale data on esophagogastroduodenoscopy (EGD) in Western countries are scarce. We conducted a prospective study on the diagnostic yield of upper gastrointestinal endoscopy in France.

PATIENTS AND METHODS

An online questionnaire was sent to all French gastroenterologists practicing endoscopy. Data from EGDs performed during one week were collected. A statistical extrapolation of the results to a whole year was performed.

RESULTS

342 gastrointestinal endoscopists, representative of the population of French gastroenterologists, provided data on 2735 EGDs, corresponding to 1 006 316 (95%CI=937 080-1 075 552) procedures for the entire year. 1770 (64.7%) EGDs were performed under sedation or general anesthesia, and 930 (34%) were associated with a colonoscopy. 896 (32.8%) EGDs were normal. Hiatal hernia and esophagitis were the most frequent esophageal diagnoses, in 496 (18.1%) and 374 (13.7%) cases, respectively. Barrett's esophagus was diagnosed in 109 (4%) patients. Among gastric lesions, endoscopic gastritis was reported in 572 (20.9%) patients; ulcer, polyps, and suspected malignancy in 78 (2.9%), 62 (2.3%), and 19 (0.7%), respectively. 1597 (58.4%) EGDs included mucosal biopsies, and 141 (5.1%) were associated with a therapeutic procedure.

CONCLUSIONS

We report nationwide prospective data on upper gastrointestinal endoscopy practice in France. Our data suggest that about 300 000 normal EGDs each year in France could potentially be avoided by a diagnostic strategy relying on upper GI capsule endoscopy, providing significant relief on healthcare practitioners.

摘要

背景和研究目的

西方国家缺乏大规模的食管胃十二指肠镜（EGD）数据。我们在法国进行了一项关于上消化道内镜诊断收益的前瞻性研究。

患者和方法

我们向所有在法国从事内镜检查的胃肠病学家发送了在线问卷。收集了一周内进行的 EGD 数据。对结果进行了全年的统计外推。

结果

342 名胃肠内镜医生，代表了法国胃肠病学家的人群，提供了 2735 例 EGD 数据，相当于整个年度的 1006316 例（95%CI=937080-1075552）。1770 例（64.7%）EGD 在镇静或全身麻醉下进行，930 例（34%）与结肠镜检查相关。896 例（32.8%）EGD 正常。食管裂孔疝和食管炎是最常见的食管诊断，分别为 496 例（18.1%）和 374 例（13.7%）。109 例（4%）患者诊断为 Barrett 食管。胃病变中，内镜胃炎报告 572 例（20.9%）；溃疡、息肉和疑似恶性病变分别为 78 例（2.9%）、62 例（2.3%）和 19 例（0.7%）。1597 例（58.4%）EGD 包括黏膜活检，141 例（5.1%）与治疗性操作相关。